Chapter 37: Anticancer Drugs (Exam 4) – Flashcards
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Cell-Cycle: Non specific
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-type of anticancer drug -alkylating agents -antitumor antibodies -hormones
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Alkylating Agents
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-type of Non Specific Cancer drug -cause cross-linking of DNA strands, abnormal base pairing, or DNA strand breaks -prevents cell from dividing. -Drugs in this group belong to the CCNS category -kill cells in various and multiple phases of the cell cycle.
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Alkylating Agents
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-type of non-specific cancer drug -treats:acute and chronic leukemias, lymphomas, multiple myeloma, and solid tumors (e.g., breast, ovary, uterus, lung, bladder, and stomach). -classified into several groups: mustard gas derivatives (e.g., cyclophosphamide [Cytoxan]), ethylenimines (e.g., thiotepa [Thioplex]), alkylsulfonates (e.g., busulfan [Myleran]), triazines (e.g., dacarbazine [DTIC]), nitrosoureas (e.g., carmustine [BiCNU]), and metal salts (e.g., cisplatin [Platinol]).
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Alkylating Agents
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-Side Effects/Adverse Reaction to___ -low RBC (Anemia) -low WBC (White Blood Cell) -low Platelet (thrombocytopenia) -GI Disturbances -Alopecia -Fatigue -Infertility
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Antitumor Antibiotics
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-type of cell specific cancer drug -(bleomycin [Blenoxane], -dactinomycin (actinomycin-D) [Cosmegen] -daunorubicin [Cerubidine, Daunomycin] -doxorubicin [Adriamycin] -mitomycin [Mutamycin] -Mitoxantrone [Novantrone])
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Antitumor Antibiotics
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-Type of non specific cancer drug -inhibit protein and RNA synthesis and bind DNA, causing fragmentation. -anthracyclines and miscellaneous drugs. Except for bleomycin, which has its major effect on the G2 phase, they are classified as CCNS drugs
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Antitumor Antibiotics
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-type of non-specific cancer drug -Except for bleomycin, which has its major effect on the G2 phase, they are classified as CCNS drugs
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Anti-tumour Antibiotics
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-Ex: Bleomycin (Blenoxane) Dactinomycin (Actinomycin D, Cosmegen) Daunorubicin HCl (Cerubidine) Doxorubicin (Adriamycin) Epirubicin (Ellence) Idarubicin (Idamycin) Mitomycin (Mutamycin) Mitoxantrone (Novantrone) Valrubicin (Valstar)
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Antitumor Antibiotics
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Side Effects/Adverse Reactions of: -alopecia, nausea, vomiting, stomatitis, and myelosuppression -vesication (blistering of tissue) *except for neomycin and mithracin
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Cell-Cycle Specific
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-type of anticancer drugs -antimetabolites -mitotic inhibitors
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Antimetabolites
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-type of cell specific anticancer drug -resemble natural metabolites that synthesize, recycle, and break down organic compounds for use by the body
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Antimetabolites
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-type of cell specifier anticancer drug -Folic Acid antagonists -Pyrimidine Antagonists -Purine Antagonists -Adenosine deaminase inhibitors -Ribonucleotide reductase inhibitors
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Antimetabolites
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-type of cell specific anticancer drug -disrupt metabolic processes and can inhibit enzyme synthesis. -They are classified as CCS and exert their effects in the S phase (DNA synthesis and metabolism) of the cell cycle
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Antimetabolites
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-type of cell specific anticancer drug -classified according to the substances with which they interfere - include folic acid (folate) antagonists (e.g., methotrexate [Rheumatrex, Trexall], pemetrexed [Altima]), pyrimidine antagonists (e.g., fluorouracil [Adrucil]), purine antagonists (e.g., 6-mercaptopurine [Purinethol]), adenosine deaminase inhibitors (e.g., fludarabine [Fludara]), and ribonucleotide reductase inhibitors (e.g., hydroxyurea (Hydrea), 2-deoxycoformycin (pentostatin [Nipent]).
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Antimetabolites
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-Side Effect of : -anorexia, nausea, vomiting, diarrhea, stomatitis, alopecia, photosensitivity, increased skin pigmentation, rash, and erythema
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MTX (Rheumatrex, Trexall) Methotrexate
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-type of Antimetabolite Drug -folic acid antagonist -used for the treatment of both cancerous and noncancerous (e.g., rheumatoid arthritis, psoriasis) conditions. - also used to induce miscarriage in patients with ectopic pregnancies -must be given with calcium
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Fluorouracil
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-type of Antimetabolite/ Pyrimidine -mainstay of treatment for a variety of cancers, including those of the breast, stomach, liver, pancreas, and skin -administered IV to treat solid tumors and topically for superficial basal cell carcinoma. - 80% is excreted by the lungs as carbon dioxide.
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Fluorouracil
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-type of Antimetabolite/Pyrimidine -blocks the enzyme action necessary for DNA and ribonucleic acid (RNA) synthesis. -use cautiously with ginseng and St. John's wort
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Flurouracil
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-type of Antimetabolite/Pyrimidine - Side Effects: anorexia, nausea, vomiting, diarrhea, stomatitis, alopecia, photosensitivity, increased skin pigmentation, rash, and erythema. -Stomatitis is an early sign of toxicity and should be reported to the physician.
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Stomatitis
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___ is an early sign of toxicity in the drug Fluorouracil
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Adjuvant Therapy
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-type of cancer chemotherapy -may be treated with surgery first, followed by chemotherapy to eliminate any residual tumor cells (microscopic metastases) that may remain in the body -ie; breast cancer, colon cancer
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Neoadjuvant Therapy
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-type of cancer chemotherapy -may be given first to help shrink a large tumor, so that it can be surgically removed
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Palliative Chemotherapy
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-type of cancer chemotherapy -used to relieve symptoms associated with advanced disease (e.g., pain, shortness of breath) and improve quality of life.
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Protocols
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-type of cancer chemotherapy -how chemotherapy administration is guided -developed based on the results of controlled research studies. -length of treatment is determined by the type and extent of the malignancy, type of chemotherapy given, expected side effects of these drugs, and the amount of time that normal cells need to recover
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Chemotherapy
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-usually given in cycles to improve the likelihood that cancer cells will be destroyed and that normal cells can recover. -duration, frequency, and number of cycles are based on the type and size of the tumor, whether the disease has spread to other areas of the body (metastasis), and the condition of the patient
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Chemotherapy
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-The duration of each treatment varies from minutes to days and may be repeated weekly, biweekly, or monthly, based on the protocol being followed.
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Combination Chemotherapy
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-type of chemotherapy -combination of CCS and CCNS -decreases drug resistance -enhances tumoricidal effects -reduces drug toxicity
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Combination Chemotherapy
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-Side Effects & Adverse Reactions to ___ - rapidly growing normal cells (e.g., skin, hair). -cells in the gastrointestinal (GI) tract, mucous membranes, bone marrow, and reproductive system. -myelosuppression
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Myelosuppression
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-significant decrease in cells in bone marrow -ie; white blood cells, platelets, red blood cells -In combination Chemotherapies
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Anticancer Therapy in Clinics and Home Settings
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-health care provider qualified to administer anticancer agents follows the policies provided by the oncologist and the home health care agency
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Anticancer Therapy in Clinics and Home Settings
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To reduce nurses exposure to Chemotherapy drugs during _____, the following steps are taken: -powder free gloves -wear gowns -respirator if necessary -face shield if there is a danger of splashing of fluids
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Mustard Gas Derivatives
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-Type of Alkylating Agents -Nitrogen mustard (Mustargen) -Chlorambucil (Leukeran) -Cyclophosphamide (Cytoxan) -Ifosfamide (Ifex) -Mechlorethamine HCl (Mustargen) -Melphalan (Alkeran) -Temozolomide (Temodar)
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Alkylating Agent
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-Mustard Gas Derivatives are a type of _____
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Nitrosureas
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-Type of Alkylating Agent -Carmustine (BiNU) -Lomustine (CeeNu, CCNU) -Srreptozocin (Zanosar)
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Alkylating Agent
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Nitrosureas are a type of ___
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Alkylating Agents
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-Alkyl Sulfonates and Busulfan (Myleran, Busuflex) are types of ___
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Alkylating-Like Drugs
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The Following drugs are: -Altretamine (Hexalen) -Carboplatin (Paraplatin) -Cisplatin (Platinol) -Oxaliplatin (Eloxatin) -Dacarbazine (DTIC) -Thiotepa (Thioplex)
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Cyclophosphamide (Cytoxan)
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-Type of Alkylating Drug - Inhibition of protein synthesis through interference with DNA replication by alkylation of DNA -immunosuppressant agent -used for: Breast, lung, ovarian cancers; leukemias; lymphomas, multiple myeloma.
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Cyclophosphamide (Cytoxan)
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-Type of Alkylating Drug -Decreases digoxin level. -Increases drug action of barbiturates, chloramphenicol half-life, and effects of anticoagulant drugs. -Duration of leukopenia may be prolonged if given with thiazide diuretics. -Potentiates doxorubicin (Adriamycin) cardiomyopathy. -Actions and toxicities of allopurinol, probenicid, colchicine, phenothiazines, potassium iodide, imipramine, warfarin, and succinylcholine are altered if given with cyclophosphamide. -Toxicity increased if given with corticosteroids, phenytoin, or sulfonamides.
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Cyclophosphamide (Cytoxan)
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-Type of Alkylating Drug -Use cautiously with garlic, ginkgo, echinacea, ginseng, St. John's wort, kava kava, grapeseed. Toxicity and actions of both cyclophosphamide and vitamin A are altered if given together
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Plant Alkaloids
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- derived from natural products that are CCS and block cell division at the M phase of the cell cycle.
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Vinca Alkaloid
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-type of plant Alkaloid -Vinblastine (Velban) -Vincristine (Oncovin) -Vinorelbine (Navelbine)
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Antimicrotubules (Taxanes)
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-type of plant alkaloid -Docetaxel (Taxotere) -Paclitaxel (Taxol) -Podophyllotoxins -Etoposide (VP-16, Pepesid], teniposide, VP26, Vumon) -Camptothecan analogues -Irinotecan (Camptosar, CPT-11], Topotecan [Hycamtin])
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Vincristine (oncovin)
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-type of plant alkaloid -obtained from periwinkle plant -given IV -Use cautiously with bromelain (an extract from the pineapple plant), which may improve the efficacy of vincristine. -Catharanthus roseus (periwinkle) may increase risk of bone marrow suppression when given with vincristine. -Schisandra extract (Schisandra, gomishi, Sheng-Mai-San) stimulates hepatic metabolism and may interfere with vincristine, which is excreted through the liver.
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Vincristine (oncovin)
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-type of plant alkaloid -Cancer of the breast, lungs, and cervix; multiple myelomas, sarcomas, lymphomas, Wilms' tumor. Assess neurologic difficulties. Used for treating Hodgkin's disease in combination therapy, MOPP -Monitor bilirubin levels. Dose may be reduced if bilirubin levels are >1.5 mg/dL. -combined with analgesics = constipation
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Vincristine (oncovin)
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-type of plant alkaloid - Monitor for signs of peripheral neuropathy (numbness and/or tingling in hands and/or feet, sensory loss, loss of deep tendon reflexes, paresthesia, foot drop, wrist drop, ataxia). -monitor bilirubin levels
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Liposomal Chemotherapy
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-Anticancer Drugs that have been packaged inside synthetic fat globules called 'liposomes'
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Liposomal Chemotherapy
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Examples of ___: -Doxorubicin (Doxil, Caelyx, Myocet) -Daunorubicin (DaunoXome) -Cytarabine (DepoCyt)
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Liposomal Chemotherapy
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-helps the chemotherapy drug remain in the system longer, decreases side effects (e.g., hair loss, nausea, cardiotoxicity), and increases the duration of therapeutic effects
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Hormonal Agents
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-class of anticancer drug -corticosteroids -sex hormones -Gonadotrophin-releasing hormone analogue -anti androgens -aromatase Inhibitors
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Corticosteroids
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-type of hormonal agent for anticancer drugs - antiinflammatory agents that suppress the inflammatory process that is associated with tumor growth. -block steroid-specific receptors on the surface of cells. -slows the growth fraction of the tumor, thus retarding its growth Side Effects: - fluid retention, potassium loss, increased risk for infection, increase in blood sugar, increased fat distribution, muscle weakness, increased bleeding tendency, and euphoria.
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Sex Hormones
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-type of hormonal agent for anticancer drugs -estrogen and androgen -used in prostate cancer and breast cancer -used to slow growth of hormone dependent tumors
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Estrogen
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____therapy is a palliative treatment used to decrease the progression of prostatic cancer in men and to slow the growth of hormone-dependent breast cancer in women. - suppress tumor growth and may induce remission of the cancer for up to 1 year
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Estrogen Therapy: Sex Hormones
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Ex: -Diethylstilbestrol (DES, Stilbestrol) -ethinyl estradiol (Estinyl) -chlorotrianisene (TACE) -conjugated estrogens (Premarin)
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Progestins
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-type of sex hormone therapy -used to treat breast cancer, endometrial carcinoma, and renal cancer
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Progestins
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-type of sex hormone therapy -Hydroxyprogesterone caproate (Duralutin) -medroxyprogesterone acetate (Depo-Provera) -megestrol acetate (Megace)
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Androgens
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___are given to treat advanced breast cancer in premenopausal women. -promotes regression of tumors. - used over a long period of time= masculine secondary sexual characteristics, such as body hair growth, lowering of the voice, and muscle growth, will occur.
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Antiestrogens
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-type of anticancer Sex Hormone Treatment -Tamoxifen (Nolvadex) -fuvestrant (Faslodex)
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Selective Estrogen Receptor Modulators (SERMs)
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-act like antiestrogens to slow tumor growth -have fewer side effects than tamoxifen
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Gonadotropin-Releasing Hormone Analogues: Luteinizing Hormone
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- suppress the secretion of follicle-stimulating hormone and luteinizing hormone from the pituitary gland. -Initially increase in testosterone levels - continued use = pituitary gland becomes insensitive to this stimulation, leading to a **reduction in the production of androgens and estrogens**
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Lutenizing Hormone
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-releases hormone (LH-RH agonist)
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Luteinizing Hormone
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EX of: ___ -Leuprolide (Lupron), goserelin (Zoladex)
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Antiandrogens
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-useful in treating men with hormone responsive prostate cancer that has metastasized
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Antiandrogens
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-EX of: ___ -Flutamide (Eulexin), nilutamide (Nilandron), bicalutamide (Casodex)
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Aromatase Inhibitors
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-Block the peripheral conversion of androgens to estrogens -suppress the postmenopausal synthesis of estrogen and slowing tumor growth
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Aromatase Inhibitors
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-EX of: ___ -Anastrozole (Arimidex) - letrozole (Femara) -exemestane (Aromasin)
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Vaccine: Gardasil -Hep B
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-Administered to girls and young women age 9 to 26 years to prevent HPV infections that can cause cervical cancer
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Vaccine: Cervarix -Hep B
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-is used for boys and young men between the ages of 9 and 26 years to prevent HPV types 6 and 11, which can cause genital warts.
